The clinical application of Febuxostat should strictly avoid specific high-risk populations, especially patients with severe liver dysfunction and those currently using specific immunosuppressants, to avoid fatal drug interactions.

1、 Severe liver dysfunction patients

Febuxostat is mainly metabolized by the liver and is contraindicated for patients with severe liver dysfunction (Child Pugh C grade).

Regular liver function tests (ALT, AST, total bilirubin) should be conducted before medication and during treatment.

If the patient has a history of severe liver disease, cirrhosis, or decompensated liver function, treatment should not be initiated.

2、 Patients receiving treatment with azathioprine or mercaptopurine

Absolute contraindication: Febuxostat can inhibit xanthine oxidase, leading to a significant reduction in the metabolic clearance of azathioprine or mercaptopurine, resulting in a sharp increase in blood drug concentration.

This interaction can cause severe bone marrow suppression (such as pancytopenia) and severe gastrointestinal toxicity, posing a potential lethal risk.

Patients currently taking the aforementioned medications should not switch to or add febuxostat; If uric acid lowering therapy is necessary, other drug options should be evaluated.

3、 Other precautions

For patients with mild to moderate liver dysfunction (Child Pugh A or B grade), dose adjustment is usually not necessary, but caution should be exercised and liver function should be closely monitored.

Before using febuxostat, any patient should fully inform the doctor of all prescription drugs, over-the-counter drugs, and health products being used.

If there are signs of liver damage such as fatigue, discomfort in the upper right abdomen, jaundice, or dark urine during medication, the medication should be stopped immediately and medical attention should be sought.